| NPI | 1346200078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD041477L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 80621) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2015-01-06 |